Frontiers in Immunology (Dec 2022)
Effect of inactivated COVID-19 vaccines on seizure frequency in patients with epilepsy: A multicenter, prospective study
- Xiqin Fang,
- Xiqin Fang,
- Shimin Hu,
- Shimin Hu,
- Shimin Hu,
- Tao Han,
- Tingting Yang,
- Tingting Yang,
- Junji Hu,
- Yucheng Song,
- Chunxiang Li,
- Aihua Ma,
- Yufeng Li,
- Qingxia Kong,
- Liou Tang,
- Wei Chen,
- Wenxiu Sun,
- Chunyan Fang,
- Yanping Sun,
- Juan Chen,
- Wenying Sun,
- Yibing Yan,
- Yuxing Gao,
- Jianhong Geng,
- Nan Li,
- Qiubo Li,
- Zhaolun Jiang,
- Shishen Lv,
- Wenke Li,
- Xiaoling Lang,
- Suli Wang,
- Yanxiu Chen,
- Baomin Li,
- Ling Li,
- Xinjie Liu,
- Yong Liu,
- Yan Zhan,
- Zaifen Gao,
- Lixin Qu,
- Qingxi Fu,
- Xuewu Liu,
- Xuewu Liu
Affiliations
- Xiqin Fang
- Department of Neurology, Qilu Hospital, Shandong University, Jinan, China
- Xiqin Fang
- Institute of Epilepsy, Shandong University, Jinan, China
- Shimin Hu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Shimin Hu
- Beijing Key Laboratory of Neuromodulation, Beijing, China
- Shimin Hu
- Institute of Sleep and Consciousness Disorders, Center of Epilepsy, Beijing institute for Brain Disorders, Capital Medical University, Beijing, China
- Tao Han
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
- Tingting Yang
- Department of Neurology, Qilu Hospital, Shandong University, Jinan, China
- Tingting Yang
- Institute of Epilepsy, Shandong University, Jinan, China
- Junji Hu
- Department of Neurology, Zibo Changguo Hospital, Zibo, China
- Yucheng Song
- Department of Neurology, Jining City Dai Zhuang Hospital, Jining, China
- Chunxiang Li
- Department of Pediatrics, Yantai Yuhuangding Hospital, Yantai, China
- Aihua Ma
- 0Department of Pediatrics, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
- Yufeng Li
- 1Department of Pediatrics, Linyi People’s Hospital, Linyi, China
- Qingxia Kong
- 2Department of Neurology, Affiliated Hospital of Jining Medical, Jining, China
- Liou Tang
- 3Department of Neurology, Affiliated Hospital of Qingdao University, Qingdao, China
- Wei Chen
- 4Department of Neurosurgery, Liaocheng People’s Hospital, Liaocheng, China
- Wenxiu Sun
- 0Department of Pediatrics, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
- Chunyan Fang
- 5Department of Neurology, Zhucheng People’s Hospital, Zhucheng, China
- Yanping Sun
- 3Department of Neurology, Affiliated Hospital of Qingdao University, Qingdao, China
- Juan Chen
- 6Department of Neurology, Heze Third People’s Hospital, Heze, China
- Wenying Sun
- 7Department of Pediatrics, Liaocheng People’s Hospital, Liaocheng, China
- Yibing Yan
- 8Department of Neurosurgery, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
- Yuxing Gao
- 0Department of Pediatrics, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
- Jianhong Geng
- 9Department of Neurology, Affiliated Hospital of Weifang Medical College, Weifang, China
- Nan Li
- 0Department of Neurology, Shengli Oilfield Central Hospital, Dongying, China
- Qiubo Li
- 1Department of Pediatrics, Affiliated Hospital of Jining Medical, Jining, China
- Zhaolun Jiang
- 2Department of Pediatrics, Tengzhou Central People’s Hospital, Zaozhuang, China
- Shishen Lv
- 2Department of Pediatrics, Tengzhou Central People’s Hospital, Zaozhuang, China
- Wenke Li
- 2Department of Pediatrics, Tengzhou Central People’s Hospital, Zaozhuang, China
- Xiaoling Lang
- 3Department of Neurology, Laizhou People’s Hospital, Qingdao, China
- Suli Wang
- 4Department of Pediatrics, Weifang Maternal and Child Health Care Hospital, Weifang, China
- Yanxiu Chen
- 5Department of Neurology, Liaocheng People’s Hospital, Liaocheng, China
- Baomin Li
- 6Department of Pediatrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Ling Li
- 7Department of Neurology, Qilu Hospital of Shandong University (Qingdao), Qingdao, China
- Xinjie Liu
- 6Department of Pediatrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Yong Liu
- 8Department of Pediatrics, Qilu Children’s Hospital of Shandong University, Jinan, China
- Yan Zhan
- 9Department of Neurology, Affiliated Hospital of Binzhou Medical College, Yantai, China
- Zaifen Gao
- 8Department of Pediatrics, Qilu Children’s Hospital of Shandong University, Jinan, China
- Lixin Qu
- 0Department of Neurology, Dezhou People’s Hospital, Dezhou, China
- Qingxi Fu
- 1Department of Neurology, Linyi People’s Hospital, Linyi, China
- Xuewu Liu
- Department of Neurology, Qilu Hospital, Shandong University, Jinan, China
- Xuewu Liu
- Institute of Epilepsy, Shandong University, Jinan, China
- DOI
- https://doi.org/10.3389/fimmu.2022.984789
- Journal volume & issue
-
Vol. 13
Abstract
ObjectivesSeveral COVID-19 vaccines list “uncontrolled epilepsy” as a contraindication for vaccination. This consequently restricts vaccination against COVID-19 in patients with epilepsy (PWE). However, there is no strong evidence that COVID-19 vaccination can exacerbate conditions in PWE. This study aims to determine the impact of COVID-19 vaccination on PWE.MethodsPWE were prospectively recruited from 25 epilepsy centers. We recorded the seizure frequency at three time periods (one month before the first vaccination and one month after the first and second vaccinations). A generalized linear mixed-effects model (GLMM) was used for analysis, and the adjusted incidence rate ratio (AIRR) with 95% CI was presented and interpreted accordingly.ResultsOverall, 859 PWE were included in the analysis. Thirty-one (3.6%) and 35 (4.1%) patients were found to have increased seizure frequency after the two doses, respectively. Age had an interaction with time. The seizure frequency in adults decreased by 81% after the first dose (AIRR=0.19, 95% CI:0.11–0.34) and 85% after the second dose (AIRR=0.16, 95% CI:0.08–0.30). In juveniles (<18), it was 25% (AIRR=0.75, 95% CI:0.42–1.34) and 51% (AIRR=0.49, 95% CI:0.25–0.95), respectively. Interval between the last seizure before vaccination and the first dose of vaccination (ILSFV) had a significant effect on seizure frequency after vaccination. Seizure frequency in PWE with hereditary epilepsy after vaccination was significantly higher than that in PWE with unknown etiology (AIRR=1.95, 95% CI: 1.17–3.24). Two hundred and seventeen (25.3%) patients experienced non-epileptic but not serious adverse reactions.DiscussionThe inactivated COVID-19 vaccine does not significantly increase seizure frequency in PWE. The limitations of vaccination in PWE should focus on aspects other than control status. Juvenile PWE should be of greater concern after vaccination because they have lower safety. Finally, PWE should not reduce the dosage of anti-seizure medication during the peri-vaccination period.
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